Age-Related Clinical, Serological, and Histopathological Features of Celiac Disease

Vivas, Santiago; Morales, José; Fernández, Marisa; Hernando, Mercedes; Herrero, Blanca; Casqueiro, Javier; Gutiérrez, Santiago

doi:10.1111/j.1572-0241.2008.01977.x

Cited by 118 publications

(96 citation statements)

References 31 publications

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“…These findings correlate well with the more-severe villous atrophy and higher titers of CD-specific Abs in this group, as measured by almost all assays. Similar differences in histological features, clinical findings, and Ab titers between younger (Յ2-year-old) and older (Ͼ2-year-old) children were recently reported by Vivas et al (35). Our findings are in agreement with those of that group and others (14).…”

Section: Discussionsupporting

confidence: 93%

“…Borderline and weak-positive results were considered positive for calculating sensitivity, specificity, PPV, NPV, and test efficiency. The participating children were divided into CD positives and negatives according to biopsy results, which are considered the gold standard for diagnosis of CD (15,17,20,26,33,35,37). Several of the clinical indications listed were more noticeable in the biopsy-negative group, namely, failure to thrive and other high-risk characteristics that might imply CD, such as diabetes mellitus type 1, hypertransaminasemia, and IgA deficiency.…”

Section: Discussionmentioning

confidence: 99%

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Performance of Serology Assays for Diagnosing Celiac Disease in a Clinical Setting

Parizade

Bujanover

Weiss

et al. 2009

Clin Vaccine Immunol

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Diagnosis of celiac disease frequently depends upon serology assays. We set out to prospectively assess the diagnostic value of five serology tests: an enzyme-linked immunosorbent assay (ELISA) for tissue transglutaminase (tTG)-immunoglobulin A (IgA) and tTG-IgG, a chemiluminescence assay for tTG-IgA, an ELISA for deamidated gliadin peptide (DGP) IgG and IgA screening, and detection of endomysial antibodies (Abs) by indirect immunofluorescence. One hundred sixteen children at high risk for developing celiac disease were evaluated clinically and underwent small bowel biopsies and blood serology tests. We examined differences between younger and older children in terms of clinical presentation, test performance, and the ability of high Ab levels to correctly predict diagnosis of celiac disease. Celiac disease was diagnosed for 85 (73%) children. No significant clinical differences were observed between the biopsy-positive and biopsy-negative groups. Children <3 years of age revealed higher concentrations of tTG-IgA and DGP Abs than children >3 years old (P ‫؍‬ 0.017 and 0.007, respectively). High Ab concentrations were predictive of villous atrophies, with sensitivities ranging from 92.8% to 97.9%, depending on the assay and the cutoff points applied. Sensitivities, specificities, positive predictive values, and negative predictive values varied among assays and improved after correction for best cutoff points. Assay specificities obtained in the clinical setting were lower than expected. The new tTG-IgA chemiluminescence assay demonstrated high throughput but low specificity (74.2%). The tTG-IgA ELISA exhibited the highest test efficiency, and the tTG-IgA chemiluminescence assay was suitable for large-scale screening, with reduced specificity. High concentrations of celiac disease-specific Abs bring into question the need for performance of biopsies on children at high risk.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Performance of Serology Assays for Diagnosing Celiac Disease in a Clinical Setting

Parizade

Bujanover

Weiss

et al. 2009

Clin Vaccine Immunol

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“…Different studies have shown that classic clinical malabsorption pattern is frequently observed in children during diagnosis, while classical symptoms occur in less than 25% of adult cases [12] . Table 1 contains an overview of different clinical manifestations in CD according to the presentation age.…”

Section: Symptomatologymentioning

confidence: 99%

“…In addition, the presence of intraepithelial lymphocytosis and/or villous atrophy and crypt hyperplasia of smallbowel mucosa, and clinical remission after withdrawal of gluten from the diet, are also used for diagnosis antitransglutaminase antibody (tTGA) titers and the degree of histological lesions inversely correlate with age [12] . Thus, as the age of diagnosis increases antibody titers decrease and histological damage is less marked.…”

Section: Diagnosismentioning

confidence: 99%

Age-related differences in celiac disease: Specific characteristics of adult presentation

Vivas

Vaquero

Rodríguez-Martín

et al. 2015

WJGPT

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Celiac disease may appear both in early childhood and in elderly subjects. Current knowledge of the disease has revealed some differences associated to the age of presentation. Furthermore, monitoring and prognosis of celiac subjects can vary depending on the pediatric or adult stage. The main objective of this review is to provide guidance for the adult diagnostic and follow-up processes, which must be tailored specifically for adults and be different from pediatric patients.

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“…Studies on the role of the gut microbiota in CD pathophysiology are still in their early stages. The main findings related to microbiota composition in CD subjects are summarized in Table 1. CD is a common disorder in both children and adults (21). Nevertheless, our knowledge about the intestinal microbiota of adults with CD is still sparse.…”

Section: Microbiota and CDmentioning

confidence: 99%

Intestinal Microbiota and Probiotics in Celiac Disease

et al. 2014

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SUMMARY Celiac disease (CD) is a common chronic autoimmune enteropathy caused by gluten intake. To date, the only therapy for CD is the complete exclusion of dietary sources of grains and any food containing gluten. It has been hypothesized that the intestinal microbiota is somehow involved in CD. For this reason, probiotics are appearing as an interesting adjuvant in the dietetic management of CD. This review aims to discuss the characteristics of the microbiota in CD subjects and the use of probiotics as a novel therapy for CD. Comparisons between children with CD and controls show that their microbiota profiles differ; the former have fewer lactobacilli and bifidobacteria. Specific probiotics have been found to digest or alter gluten polypeptides. It has also been demonstrated that some bacterial species belonging to the genera Lactobacillus and Bifidobacterium exert protective properties on epithelial cells from damage caused by gliadin.

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Age-Related Clinical, Serological, and Histopathological Features of Celiac Disease

Abstract: At initial diagnosis, CD shows age-related differences, which consist of more evident clinical and histological features in children. Furthermore, IgA TTGA levels correlate both with the degree of villous atrophy and with the patient's age.

Cited by 118 publications

References 31 publications

Performance of Serology Assays for Diagnosing Celiac Disease in a Clinical Setting

Performance of Serology Assays for Diagnosing Celiac Disease in a Clinical Setting

Age-related differences in celiac disease: Specific characteristics of adult presentation

Intestinal Microbiota and Probiotics in Celiac Disease

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